According to Johns Hopkins University, over 19 million people have contracted COVID-19 as of August 9, 2020.  The Philippines has a total of 129,913  confirmed cases—of which 59,970 are active, 2,270 are deaths, and 67,673 are recoveries.  

Each day, the Department of Health holds press briefings and closely works with a task force that has worked diligently since its creation. The Philippines now ranks number 1 in testing capacity in Southeast Asia for confirmed and active cases.  

With our increase in testing capacity, full health campaign for combatting COVID-19, and a cooperative nation wearing masks, what else is missing?  Given these measures, the Philippines should be having less cases.  

Getting the Fundamentals Right 

Filipinos seem to be overwhelmed with the deluge of instructions as well as misinformation and disinformation. Though the Department of Health(DOH) is endorsed as the official source of local data, and the World Health Organization for global data, there are just to many well-meaning people who forward unverified information.

DOH sought a new endorser, the popular actor, Alden Richards, to proclaim its new campaign—BIDA Solusyon. It’s a catchy phrase, playing on the Filipino word bida, which means “the lead star”. BIDA Solusyon, which wittingly sounds like “Be the Solution”, shows in part animation how to combat COVID-19. BIDA serves as an acronym for four steps: 

B – Bawal walang mask. 

I – Isanitize ang mga kamay; iwas-hawak sa mga bagay.

D – Dumistansiya ng isang metro.

A – Alamin ang totoong impormasyon.

The messaging is light and friendly, and easy to digest.  

Gaps in the Messaging

But the acronym, though clever, seems to be missing a step in achieving ”minimum health standards”. Before wearing a mask, one should wash hands properly with soap and water, scrubbing them for at least 20 seconds as recommended by the Centers for Disease Control and Prevention before rinsing. When one uses dirty and infected hands to put on the mask, the preventive measure becomes ineffective.

The public’s proper and consistent compliance spells the difference between life and death. But with this massive campaign on handwashing and hand sanitizing, there is also a need to consider areas with no running water and basic facilities for sanitation. How can people wash their hands with water and soap when there’s no water to begin with?

Masking the Problem

The WHO has already approved cloth masks as basic protection. This cannot be emphasized enough: masks need to be worn at all times outside the home, especially when one is in an enclosed space with other people.  

Proper use of the mask means having the nose and face covered and securing it under the chin. Make sure the sides of your face are covered, but also check if you’re breathing easily. Don’t let it rest on your chin or forehead as contact with exposed skin may result in a contaminated mask.

After using a disposable mask, remove it from behind and discard it in a closed bin. Make sure to wash cloth masks after use. And most importantly, wash hands with soap and water after using masks. 

The words to remember when wearing masks are properly, correctly, and consistently.

Utilizing TV for Information 

According to Digital 2019, a report from Hootsuite and We are Social, 76 million Filipinos are internet users, all of them on social media. But our internet speed remains at a dismal 19 mbps, a tenth of Singapore’s fixed connection speed of 190.9. Also, there are still areas in the Philippines without proper internet infrastructure and poor cellular signal.

At this time, the government has to fully utilize its TV and radio broadcast channels to disseminate information on health, agriculture, and entrepreneurship. To retool and upskill citizens, trainings from the Technical Education and Skills Development Authority (TESDA), and even first aid, can be broadcast through mass media—with testing and accreditation to be done in barangays.

Going Analogue

The DOH recently launched an app for contact tracing. Upon a recent audit, the country’s new contact trace czar Benjamin Magalong found the contact tracing system of cities and barangays lacking.

But even in our own homes, we can employ our own simple system with just  a piece of paper and a pen. By dividing the paper into columns of Date, Time, Venue, Activity and People We’ve Interacted with, we can maintain a contact trace system in our household, making it easier for authorities to respond should one be confirmed positive for COVID-19.  

Getting the Basics Down Pat

Going back to basics, getting the fundamentals right is a simple exercise that we can all do.  Ask yourself today—did you wash your hands properly?  Did you wear your mask properly? 

Perhaps our leaders can also ask themselves—is everyone equipped with running water to ensure their health and safety? What is the best way to disseminate information? Does everyone have a home to seek refuge in while the deadly virus roams freely outside? Before we run, we need to first walk. Before we can help save lives,  we must be able to help ourselves first.

The COVID-19 pandemic is teaching us lessons the hard way, but with proper planning, we don’t need to learn them the hard way.  

Donna May Lina

9 August 2020

Zika, the mosquito-borne virus captured international attention in early 2015 when an outbreak hit Brazil, where almost 7,000 cases were reported. Since then, researchers have been linking the virus to neurogical disorders, such as the Guillain-Barre Syndrome characterized by the sudden weakening of muscles; and Microcephaly, a congenital disorder that causes babies to be born with underdeveloped brains and abnormally small heads.
As information about the virus continuously evolves, Zika’s reach continues to widen. Currently, it affects 57 countries, including those in Africa, Asia, and the Pacific Islands.

The Mosquito and Transmission

In 1952, the first human Zika cases were detected in Uganda and the United Republic of Tanzania. In the next decades, its outbreak was reported on the island of Yap, located in the Caroline Islands, part of the Federal States of Micronesia.
Zika is carried by arthropods, particularly mosquitoes and ticks. It is usually transmitted when an Aedes mosquito bites a person with an active infection, and then spreads the virus through consequent bites. It is the same type of mosquito that carries Dengue fever, yellow fever, and the Chikungunya virus. These mosquitoes are aggressive daytime biters, but may also bite at night. Recently, researchers confirmed that ZIka could be sexually transmitted.

Signs and Symptoms

In the majority of cases, Zika Virus infection is asymptomatic, which means that victims do not exhibit the following symptoms until 3 to 12 days after being bitten by an infected mosquito:
• Mild fever, headache, muscle pain and joint pain
• Nausea, vomiting, and general malaise
• Pink eye (inflammation of conjuctiva)
• Skin rash on the face, neck, trunk and upper arms, which can spread to the palms or soles
• Sensitivity to light.
• Lack of appetite, diarrhea, abdominal pain, constipation, and dizziness

Most people fully recover from the illness within 7 days. But pregnant women are among those who are in most danger when infected by the disease, since the virus can be passed on to the fetus, which may suffer from the neurological defect, Microcephaly.

Zika in PH

Our country confirmed its first Zika case last August this year. A 45 year-old woman from Iloilo City tested positive for both strains of the virus, after complaining about skin rash and joint pains, which are common symptoms of this virus. Later, two more cases were reported from the same household. In September, the virus was reported in three provinces. Seven patients came from Iloilo City, one from Cebu and one from Laguna province. Recently, ten more cases were added to the list.
According to the Department of Health, the Philippines has a total of 33 cases. The first pregnant case in the country is a 22-year-old from Cebu. Initial examination through ultrasound revealed no detectable fetal abnormalities.
For more details on combatting Zika, Dengue and Chikungunya, watch this:

Even before the onset of the Hot and Dry season, parts of the Philippines have already been experiencing hot weather conditions.

That’s why we need to learn how to protect ourselves from the heat, especially those who are at greater risk during this season. These include elderly people aged 65 and above, infants, young children, people who are overweight, with chronic diseases, with mental illness, and even healthy individuals undergoing strenuous physical activities during the hot months. They are the most vulnerable to heat-related incidents as high temperatures can affect the body’s ability to release heat and properly cool down.

HEAT EXHAUSTION
Being exposed to high temperatures and inadequate intake of water can result to heat exhaustion. Water depletion and salt depletion are two types of this illness. Although this is not as serious as heat stroke, heat exhaustion is not to be taken lightly as it may progress to heat stroke if left untreated.

Warning Signs:
• Dehydration, intense thirst
• Warm, flushed skin
• Dizziness or fainting
• Weakness or discomfort
• Anxiety
• Headache
• Fatigue

HEAT STROKE
The most serious of heat-related illnesses, heat stroke occurs when the body overheats and is unable to cool down.

This is a life-threatening emergency that may cause permanent disability or worse, death, if medical assistance is not immediately provided.

Warning Signs:
• Very high fever
• Rapid heartbeat
• Nausea and vomiting
• Convulsion
• Delirium
• Unconsciousness

HEAT CRAMPS
Individuals, who remain physically active in hot weather, engaging in activities such as exercise, sports, and extensive manual labor, are vulnerable to heat cramps. These are intermittent, involuntary muscle spasms, and are often associated with dehydration.

Most cases occur in the thigh and leg areas, the core and arm muscles during or after exerting effort in a hot environment.

Warning Sign:
• Muscle spasms that are painful, involuntary, intermittent and may be more intense that the typical muscle cramps

PRICKLY HEAT
Prickly heat or bungang araw is a skin condition characterized by tiny bumps or water blisters that appear due to the clogging of sweat glands during hot and humid weather.

Its most common locations are the forehead, upper back and chest, armpits, and groin areas.

Warning Signs:
• Prickly sensation
• Red bumps or rashes on the skin
• Mild swelling of the affected part

SUNBURN
The most obvious result of staying under the sun for too long is sunburn. It is the term used for reddish, irritated and sometimes, painful skin caused by overexposure to ultraviolet (UV) rays of the sun. It may vary from mild to severe, the extent depending on skin type, amount of exposure to the sun, and the sun’s intensity.

Warning Signs:
• Reddening of the skin
• Development of blisters
• Fever or chills
• Nausea
• Headache
• Weakness
• Itchiness
• Peeling skin

SORE EYES
Another health woe during this season is sore eyes. Also known as conjunctivitis, this is characterized by redness and inflammation of the membranes in the eyes.

It can spread through direct contact with hands contaminated with eye secretions of an infected person, or through other things contaminated with the virus. This can also be acquired by swimming in poorly chlorinated pools.

Warning Signs:
• Watery to pus-like discharge
• Redness of the eye with pain and/or itchiness
• Eyelids stuck together upon waking up

Vacation time, coupled with hot weather conditions, is perfect for different types of outdoor activities. But remember to keep cool and use common sense so you stay healthy during the hottest days of the year.

Here are important tips to prevent heat-related woes:
• Drink plenty of water and replace the salts lost through perspiration.
• Avoid intake of tea, coffee, soda and alcohol to lessen chance of dehydration.
• Schedule rigorous physical activities at the beginning or the end of the day when it’s cooler.
• Take a bath every day.
• Wear light and loose clothing.
• Limit exposure to the sun.
• Wear sunscreen with at least SPF 30 to avoid sunburn prior to going out. Reapply it during the day.
• Adjust to the environment; pace yourself and take it easy.
• Do not leave infants, children, or pets in a parked car.
• Stay up-to-date with weather reports to gauge how long you can stay out in the sun.

Sources:
National Center for Health Promotion
Department of Health

According to the US-based Center for Disease Control and Prevention (CDC), Ebola is a rare and fatal disease caused by infection with a strain of Ebola virus. The fact that the 2014 Ebola epidemic is the largest in history should be enough motivation for everyone to know the basics of the disease.

Ebola explained
Ebola has become a topic of conversation these past few months due to the alarming cases reported all over the globe, especially in numerous West African countries. Various scientists, as well as international and local health organizations, have been doing their best to raise public awareness to help prevent the spread of this malignant disease.

Historically, the first case of Ebola was recorded in 1976, when a young Belgian scientist named Peter Piot travelled to a remote area in Congo to find out the cause of death from an unidentified disease.

The virus was primarily discovered in the Yambuku village but since naming the virus after the village may be deemed as offensive, Piot’s team decided to name it after the nearest river. According to Live Science, one option was the Congo River. However, the Crimean-Congo hemorrhagic fever virus was already in existence.

With the help of a small map, they plotted out the nearest river from Yambuku and that was the Ebola River. Ebola River means “Black River” in Lingala, the language spoken in the Democratic Republic of Congo (DRC).

Symptoms and Transmission

The Ebola Virus Disease or EVD is one of the most virulent viral diseases affecting humankind. It is a viral haemorrhagic fever with symptoms of fever, headache, intense weakness, joint and muscle pains, sore throat, vomiting, diarrhea, stomach pain, impaired kidney and liver functions, and internal and external bleeding. Rash, red eyes, hiccups and bleeding from body openings could occur in some instances.

The Department of Health (DOH) clarified that Ebola cannot be spread through air, water or food. The disease can be transmitted only through direct contact with the body of a deceased person; blood secretions, organ or other bodily fluids of infected animals; and body fluids and stools of an infected person via blood, vomit, pee, poop, sweat, semen or spit. One can also get the virus by using contaminated needles and soiled linen used by infected patients.

Healthcare and laboratory workers who are exposed to secretions and specimens from the patient and family members, or those who are in close contact with the infected individuals, are prone to the virus.

EVD knows no boundaries

Because of the EVD outbreak in West Africa, an area known for its hot and dry climate, some have speculated that it may be a weather-related disease. But according to Dr. Lyndon Lee Suy of the Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC), there is no scientific proof that weather affects the spreading of the Ebola virus. He added that as of now, there are no studies yet on how cold or warm weather stimulates the virus.

According to the CDC, countries with widespread transmission include Guinea, Liberia and Sierra Leone while those with localized transmission are Madrid, Spain; Dallas, Texas and New York City, New York in United States. Mali in West Africa was affected with travel-associated cases.

Meanwhile, Nigeria and Dakar, Senegal were already declared Ebola-free by the World Health Organization (WHO).

Based on WHO’s report, more than 10,000 confirmed, probable and suspected cases of EVD have been reported in Guinea, Liberia, Mali, Sierra Leone, Spain and United States of America. Out of this number, nearly 5,000 patients have been reported dead.

Table: Chronology of previous Ebola virus disease outbreaks

Actions taken in the PH

In a press release of DOH dated on October 17, 2014, the department stated that it will conduct specialized training programs to raise awareness and response to EVD. With the help of WHO, the programs aim to deepen the understanding of health workers on the detection and treatment of EVD cases and to stop the infectious disease from spreading.

The training programs started on October 28 when Dr. Lyndon Lee Suy led the “Training on Hospital Management of Ebola Virus Disease” held at the Research Institute for Tropical Medicine in Alabang, Muntinlupa.

Sources:
Department of Health
World Health Organization
Center for Disease Control and Prevention
Live Science
http://www.bbc.com/news/magazine-28262541